Issue no. 4 (October 1964)includes article "Reliability engineering for open heart surgery" with multiple photographs and diagrams. On cover page "Published four times a year, January, April, July and October, jointly by the Faculty of Medicine, School of Medicine of the University of Maryland, and the Medical Alumni Association." (v. 49, no. 1 (January 1964)- no. 4 (October 1964)).